Affordable Care Act Archives - Page 11 of 15 - Safety-Net Association of Pennsylvania

SNAP Endorses PA Medicaid Expansion

The Safety-Net Association of Pennsylvania has endorsed Pennsylvania’s application for a waiver from selected federal Medicaid requirements so the state can expand its Medicaid program as envisioned under the Affordable Care Act.
Instead of expanding its current Medicaid program, however, the Corbett administration proposes that the newly eligible purchase approved private insurance plans, with the state to pay the premiums. This is part of the administration’s Healthy Pennsylvania proposal.
In endorsing the waiver application in a letter to Health and Human Services Secretary Kathleen Sebelius, SNAP expressed particular support for its proposal to create a Healthy Pennsylvania Safety Net Pool that would include an Uncompensated Care Pool and/or a Delivery System Reform Incentive Pool. The additional funding associated with such pools, SNAP believes, would help safety-net hospitals address the distinct needs of the low-income communities such hospitals serve.
See the letter of endorsement here, on the SNAP web site.

PA Safety Net Admin2014-04-04T09:53:00+00:00April 4th, 2014|Affordable Care Act, Health care reform, Healthy PA, Pennsylvania Medicaid policy, Safety-Net Association of Pennsylvania|Comments Off

Healthy PA, Medicaid Expansion in Jeopardy?

Pennsylvania Governor Tom Corbett has publicly expressed concern over whether the federal government will approve the state’s attempt to expand its Medicaid program under terms made possible by the federal health care reform law.
Both Corbett and Department of Public Welfare Secretary Beverly Mackereth have suggested that negotiations between the state and federal officials have not been going well.
The state submitted an application for a waiver from selected federal Medicaid requirements in February and has modified its proposal once since then, withdrawing a controversial mandatory job-search requirement. The application is currently undergoing a period of open public comment while state and federal officials negotiate its terms.
Under the Corbett administration’s Healthy Pennsylvania proposal, the state would expand Medicaid eligibility as envisioned under the federal Affordable Care Act but instead of simply opening up its current Medicaid program to the newly eligible, it would underwrite their enrollment in private health insurance plans chosen by those individuals.
Learn more about the latest developments in the state’s attempt to take Medicaid expansion in a decidedly different direction in this Philadelphia Inquirer article.

PA Safety Net Admin2014-04-03T08:54:11+00:00April 3rd, 2014|Affordable Care Act, Health care reform, Healthy PA, Pennsylvania Medicaid policy|Comments Off

PA Learns of 43,000 New Medicaid Applicants

The federal government has sent to Pennsylvania state officials data on 43,000 people whose applications for Medicaid eligibility have been tied up for months in the federal government’s computers as part of the troubled launch of the healthcare.gov web site.
Most of the applicants will be contacted by Department of Public Welfare caseworkers while applications for the Children’s Health Insurance Program (CHIP) will be handled by the state Insurance Department.
Learn more about this situation in this article on the web site of KYW radio.

PA Safety Net Admin2014-03-12T06:00:18+00:00March 12th, 2014|Affordable Care Act|Comments Off

PA Submits Medicaid Plan to Feds

Yesterday the Corbett administration submitted a waiver application to the federal government requesting permission to expand the state’s Medicaid program as described in its “Healthy Pennsylvania” proposal.
The Pennsylvania proposal seeks to vary from the approach taken by most states expanding their Medicaid programs in accordance with the Affordable Care Act by directing the expansion population into private health insurance plans.
A draft waiver application, released in December, was the subject of public hearings throughout the state. The Safety-Net Association of Pennsylvania (SNAP) testified at one of those hearings and also submitted detailed written comments about the proposal; both can be found here.
The state’s waiver application, the December draft application, a summary of the application, and the written and oral comments about the proposed application submitted by interested parties can be found here, on the Pennsylvania Department of Public Welfare’s web site. Learn more about the proposal’s submission to the federal government and where it goes from here in this Ellwood City Ledger article and the reaction of some elected officials to the submission here.
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PA Safety Net Admin2014-02-20T06:00:20+00:00February 20th, 2014|Affordable Care Act, Health care reform, Healthy PA, Pennsylvania Medicaid policy, Safety-Net Association of Pennsylvania|Comments Off

First Round of Data on PA Health Insurance Sign-Ups

123,681 Pennsylvanians signed up for health insurance through the federally facilitated marketplace between October 1 and February 1, according to a new report from the U.S. Department of Health and Human Services.
Among Pennsylvanians who enrolled in new health insurance plans, 79 percent were eligible for financial assistance with their premiums and 56 percent are female while 44 percent are male.
Among those who enrolled in insurance plans through the marketplace, 26 percent are between the ages of 18 and 34; 15 percent are between the ages of 35 and 44; 22 percent are between 45 and 54; and 36 percent are between 55 and 64.
In all, the marketplace evaluated 286,926 Pennsylvanians for eligibility for subsidized insurance, Medicaid, and the Children’s Health Insurance Program (CHIP). 29,365 were found eligible for Medicaid or CHIP.
Learn more about the first round of Pennsylvanians who signed up for health insurance, including the types of plans they selected and more, in this Department of Health and Human Services report.

PA Safety Net Admin2014-02-14T06:00:26+00:00February 14th, 2014|Affordable Care Act|Comments Off

PA Labeled “State to Watch” for Medicaid in 2014

The Corbett administration’s “Healthy Pennsylvania” Medicaid expansion proposal has earned the commonwealth recognition from the Washington Post’s “Wonkblog” feature as one of four “states to watch” in 2014.
The Post notes that “How much flexibility the Obama administration grants to Pennsylvania could be influential to the other states, still sitting on the sidelines, waiting to decide whether to expand their own Medicaid programs in the future.”
The other states to watch cited by the Post are Arkansas, approved to use federal Medicaid money to purchase private insurance for its Medicaid population but now in jeopardy of backing out of its own expansion plan; Virginia, where a serious effort is expected to expand the state’s Medicaid program; and Utah, whose governor has declared that doing nothing “is off the table.”
Read the Washington Post article “The four most important states to watch on Obamacare’s Medicaid expansion” here.

PA Safety Net Admin2014-01-30T14:16:11+00:00January 30th, 2014|Affordable Care Act, Health care reform, Healthy PA, Pennsylvania Medicaid policy|Comments Off

The Path to PA’s Medicaid Waiver

The Corbett administration’s Healthy Pennsylvania proposal seeks to go where only two states have gone so far with their Affordable Care Act-enabled Medicaid expansion: the unconventional route.
While many of the states that have chosen to expand their Medicaid programs under the terms of the Affordable Care Act did so by embracing those terms, others are viewing Medicaid expansion as an opportunity to pursue wholesale changes in how they serve their low-income residents.
Arkansas and Iowa have already received federal waivers – exemptions from selected aspects of existing Medicaid law– to expand their Medicaid programs. Under these waivers, the states operate demonstration programs to test the effectiveness of their variations on ordinary Medicaid practices.
Pennsylvania seeks to follow in their path, and Virginia, New Hampshire, Indiana, and possibly a few other states are expected to do the same in 2014.
Learn more about the path to obtaining such a waiver and the challenges Pennsylvania may face along the way in this Stateline report.

PA Safety Net Admin2014-01-28T06:00:55+00:00January 28th, 2014|Affordable Care Act, Healthy PA, Pennsylvania Medicaid policy|Comments Off

CMS Offers Advice on Managing Expected Upsurge in ER Visits

With Medicaid enrollment rising because of eligibility changes introduced through the Affordable Care Act, hospital emergency rooms expect to see an increase in the number of emergency room visits as new Medicaid enrollees seek care for long-neglected health problems.
In anticipation of this rise in ER visits, the Centers for Medicare & Medicaid Services (CMS) has issued an informational bulletin with suggestions for hospitals on how to manage the expected increase in ER utilization.
Among CMS’s suggestions are for hospitals to broaden access to primary care services (because much of the increased utilization will be because the newly insured still do not know where to turn for care); focus on helping especially frequent ER visits find more appropriate sources of care; and target the needs of people with behavioral health problems.
This influx of new ER patients will pose a challenge for Pennsylvania’s safety-net hospitals because even though the state has not expanded its Medicaid eligibility criteria as provided for in the Affordable Care Act, other reform-related measures should result in some increase in the state’s Medicaid population.
To learn more about CMS’s recommendations for addressing this ER challenge, including some of the legal and reimbursement-related challenges this will pose, see the CMS informational bulletin “Reducing Nonurgent Use of Emergency Departments and Improving Appropriate Care in Appropriate Settings.”

PA Safety Net Admin2014-01-24T06:00:53+00:00January 24th, 2014|Affordable Care Act|Comments Off

CHIP Option Granted Temporary Stay in PA

Children currently receiving Children’s Health Insurance Program (CHIP) benefits in Pennsylvania will have the option of remaining in the program for one more year.
This comes as a result of negotiations between state officials and the U.S. Department of Health and Human Services.
Under the Affordable Care Act, children eligible for CHIP benefits who previously did not qualify for Medicaid now do qualify for Medicaid and the federal government expected states to fold these CHIP participants into their Medicaid programs. Pennsylvania officials, however, argued that CHIP participants often had a broader choice of providers than Medicaid recipients and that taking those children out of CHIP would damage the continuity of care they were receiving.
State and federal officials negotiated this issue for months until this week, when federal officials announced that Pennsylvania children in families whose income is between 100 percent and 133 percent of the federal poverty level can choose whether to remain in CHIP or move to the state’s Medicaid program. That choice ends at the close of 2014, when these participants will be enrolled in Medicaid.
CHIP insurers will mail information about this option to the 30,000 affected families.
To learn more about this issue and how it might affect care for low-income children, see this news release from the Pennsylvania Insurance Department.

PA Safety Net Admin2014-01-23T06:00:39+00:00January 23rd, 2014|Affordable Care Act, Pennsylvania Medicaid policy|Comments Off

Safety-Net Hospitals Hurt More by Readmissions Reduction Program

Hospitals that care for large numbers of low-income seniors are disproportionately harmed by Medicare’s hospital readmissions reduction program, according to a new study.
According to the study,

Both patient dual-eligible status and a hospital’s dual-eligible share of Medicare discharges have a positive impact on risk-adjusted hospital readmission rates. Under current Centers for Medicare and Medicaid Service methodology, which does not adjust for socioeconomic status, high-dual hospitals are more likely to have excess readmissions than low-dual hospitals. As a result, HRRP penalties will disproportionately fall on high-dual hospitals, which are more likely to have negative all-payer margins, raising concerns of unintended consequences of the program for vulnerable populations.

Because they care for so many more low-income patients than the typical hospital, Pennsylvania’s safety-net hospitals are especially vulnerable to the Medicare hospital readmissions reduction program’s financial penalties.
The study, “The Medicare Hospital Readmissions Reduction Program: Potential Unintended Consequences for Hospitals Serving Vulnerable Populations,” was published recently in Health Services Research and can be found here.

PA Safety Net Admin2014-01-22T06:00:20+00:00January 22nd, 2014|Affordable Care Act|Comments Off

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